The Clinical journal of pain
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The primary goal of this study was to investigate the incidence of chronic pain 1 year after a thoracotomy. Secondary goals were to determine which interventions and patient characteristics were associated with reports of chronic pain, to identify risk factors, to clarify the neuropathic component, and to determine the impact of chronic pain on daily life. ⋯ Chronic pain is common after thoracotomy and its neuropathic component is infrequent. As age, ASA scores, number of drains, and situations relating to daily life seem to play a role in pain occurrence, a multifaceted approach against the onset of chronic pain is advisable.
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Analgesic use is common but remains poorly described among human immunodeficiency virus (HIV)-infected persons in the highly active antiretroviral therapy era. ⋯ In the highly active antiretroviral therapy era, up to 15% of HIV Outpatient Study patients used prolonged analgesic therapy each year. Variables associated with the initiation of prolonged analgesia included HIV and non-HIV-related factors.
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Phantom limb perception is common following amputation, and is sometimes characterised by pain that resembles the characteristics, intensity or location of past pain. We tested Flor's model that phantom pain results from memory for long-lasting znoxious input. ⋯ We propose that somatosensory pain memories likely relate to the generation and maintenance of limb representations upon which intense or emotionally powerful past experiences have been imprinted.
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Multicenter Study
The Discriminative validity of "nociceptive," "peripheral neuropathic," and "central sensitization" as mechanisms-based classifications of musculoskeletal pain.
Empirical evidence of discriminative validity is required to justify the use of mechanisms-based classifications of musculoskeletal pain in clinical practice. The purpose of this study was to evaluate the discriminative validity of mechanisms-based classifications of pain by identifying discriminatory clusters of clinical criteria predictive of "nociceptive," "peripheral neuropathic," and "central sensitization" pain in patients with low back (± leg) pain disorders. ⋯ By identifying a discriminatory cluster of symptoms and signs predictive of "nociceptive," "peripheral neuropathic," and "central" pain, this study provides some preliminary discriminative validity evidence for mechanisms-based classifications of musculoskeletal pain. Classification system validation requires the accumulation of validity evidence before their use in clinical practice can be recommended. Further studies are required to evaluate the construct and criterion validity of mechanisms-based classifications of musculoskeletal pain.
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The link between chronic back pain and disability is well established. Despite this, the literature also reflects an inconsistency in methods of assessing disability, as studies interchangeably use self-report measures, clinical tests, and electronic monitoring. The purpose of this study was to conduct a multimethod comparison of disability measures to identify similarities and differences in the constructs measured by each. ⋯ The results indicate substantial differences in the types of variables that predict disability when measured through 3 different methods. This is suggestive of differences in the constructs measured by each type of disability assessment. The implications for researchers who assess predictors of disability and clinicians who use disability measures in their assessment of patients are that the measures of disability they select should be carefully matched to the proposed purposes. Strong theoretical and practical considerations support using electronic ambulatory monitoring in future research and clinical service.